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Choledochal cyst: a changing pattern of presentation
V Kabra1, M Agarwal, T K Adukai
1Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
ANZ Journal of Surgery
|March 30, 2001
Summary
Choledochal cysts present differently now, with older patients and fewer classic symptoms. Hepaticoduodenostomy offers an effective surgical alternative to hepaticojejunostomy for choledochal cyst treatment.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Pediatric Surgery
Background:
- Choledochal cysts are congenital biliary anomalies.
- This study investigates the changing presentation patterns and surgical outcomes for choledochal cysts.
Purpose of the Study:
- To analyze the spectrum of choledochal cyst presentations.
- To evaluate the efficacy of different surgical interventions for choledochal cysts.
Main Methods:
- A prospective study of 10 patients with choledochal cysts (1996-2000).
- Diagnosis confirmed via ultrasonography and endoscopic retrograde cholangiopancreaticography (ERCP).
- Surgical procedures included cyst excision with hepaticoduodenostomy or Roux-en-Y hepaticojejunostomy, and cystoduodenostomy.
Main Results:
- Eight patients underwent cyst excision; four each had hepaticoduodenostomy and hepaticojejunostomy.
- One patient with hepaticoduodenostomy had a minor, conservatively managed leak.
- All patients remained asymptomatic at a median follow-up of 36.5 months.
Conclusions:
- Choledochal cyst presentation is evolving, with a higher mean age and less frequent classical triad.
- Hepaticoduodenostomy is a viable, effective, and potentially less complex alternative to hepaticojejunostomy for reconstruction.